tbuckley/cabot-search huggingface dataset:
High- versus Low-Flow Extracorporeal Respiratory Support in Experimental Hypoxemic Acute Lung Injury
Authors: Serena Brusatori, Carmelo Zinnato, Mattia Busana, Federica Romitti, Simone Gattarello, Maria Michela Palumbo, Tommaso Pozzi, Irene Steinberg, Paola Palermo, Stefano Lazzari, Roberta Maj, Mara Velati, Rosanna D’Albo, Jona Wassong, Killian Meissner, Fabio Lombardo, Peter Herrmann, Michael Quintel, Onnen Moerer, Luigi Camporota, John J. Marini, Konrad Meissner, Luciano Gattinoni
Journal: American Journal of Respiratory and Critical Care Medicine (2023)

Rationale: In the ECMO to Rescue Lung Injury in Severe ARDS (EOLIA) trial, oxygenation was similar between intervention and conventional groups, while minute ventilation was reduced in the intervention group. Comparable reductions in ventilation intensity are theoretically possible with low-flow extracorporeal CO2 removal (ECCO2R), provided that oxygenation remains acceptable. Objectives: To compare the effects of ECCO2R and extracorporeal membrane oxygenation (ECMO) on gas exchange, respiratory mechanics and hemodynamics in animal models of pulmonary (intratracheal HCl) and extra-pulmonary (intravenous oleic acid, OA) lung injury. Methods: 24 pigs with moderate-severe hypoxemia (PaO2/FiO2≤150mmHg) were randomized to ECMO (blood flow 50-60mL/kg/min), ECCO2R (0.4L/min) or mechanical ventilation alone. Measurements: Oxygen consumption, CO2 production, gas exchange, hemodynamics and respiratory mechanics, presented as 24-hour average. Main results: OA vs HCl showed higher extravascular lung water (1424±419 vs 574±195mL, p<0.001), worse oxygenation (PaO2/FiO2 125±14 vs 151±11mmHg, p<0.001) but better respiratory mechanics (plateau pressure 27±4 vs 30±3cmH2O, p=0.017). Both models led to acute severe pulmonary hypertension. In both models ECMO (3.7±0.5L/min), compared to ECCO2R (0.4L/min), increased mixed venous SO2 and oxygenation, and improved hemodynamics (cardiac output 6.0±1.4 vs 5.2±1.4L/min; p=0.003). Oxygen consumption and CO2 production – irrespective of lung injury model – were lower during ECMO, resulting in lower PaCO2, minute ventilation but worse respiratory elastance compared to ECCO2R (64±27 vs 40±8cmH2O/L, p<0.001). Conclusions: ECMO was associated with better oxygenation, lower oxygen consumption, and better hemodynamics. ECCO2R may offer a potential alternative to ECMO, but the concerns are its effects on the hemodynamics and pulmonary hypertension. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Magnitude of Synchronous and Dyssynchronous Inspiratory Efforts during Mechanical Ventilation: A Novel Method
Authors: Irene Telias, Matías Madorno, Tài Pham, Thomas Piraino, Rémi Coudroy, Michael C. Sklar, Eumorfia Kondili, Savino Spadaro, Tobias Becher, Chang-Wen Chen, Tommaso Mauri, Lise Piquilloud, Laurent Brochard, Laurent Brochard, Irene Telias, Felipe Damiani, Cesar Santis, Tài Pham, Thomas Piraino, Michael Sklar, Audery Kim, Megan Abbott, Tommaso Mauri, Elena Spinelli, Giacomo Grasselli, Nadia Corcione, Francesca Dalla Corte, Savino Spadaro, Carlo Alberto Volta, Francesco Mojoli, Dimitris Georgopoulos, Eumorfia Kondili, Stella Soundoulounaki, Tobias Becher, Norbert Weiler, Dirk Schaedler, Oriol Roca, Manel Santafe, Jordi Mancebo, Nuria Rodriguez, Leo Heunks, Heder de Vries, Chang Wen Chen, Jian-Xin Zhou, Guang-Qiang Chen, Nuttapol Rittayamai, Norberto Tiribelli, Sebastian Fredes, Ricard Artigas Mellado, Carlos Ferrando Ortolá, François Beloncle, Alain Mercat, Jean-Michel Arnal, Jean-Luc Diehl, Romy Younan, Alexandre Demoule, Martin Dres, Quentin Fossé, Sébastien Jochmans, Jonathan Chelly, Nicolas Terzi, Claude Guérin, Elias Baedorf Kassis, Jeremy Beitler, Davide Chiumello, Erica Ferrari Luca Bolgiaghi, Arnaud W. Thille, Rémi Coudroy, Laurent Papazian, C. Guervilly, Ewan C. Goligher, Niall D. Ferguson
Journal: American Journal of Respiratory and Critical Care Medicine (2023)

"Magnitude of Synchronous and Dyssynchronous Inspiratory Efforts during Mechanical Ventilation: A Novel Method." American Journal of Respiratory and Critical Care Medicine, 207(9), pp. 1239–1243
Alteration patterns of peripheral concentrations of cytokines and associated inflammatory proteins in acute and chronic stages of schizophrenia: a systematic review and network meta-analysis
Authors: Sean Halstead, Dan Siskind, Michaela Amft, Elias Wagner, Vladislav Yakimov, Zoe Shih-Jung Liu, Ken Walder, Nicola Warren
Journal: The Lancet Psychiatry (2023)
Harnessing imaging tools to guide immunotherapy trials: summary from the National Cancer Institute Cancer Imaging Steering Committee workshop
Authors: Lalitha K Shankar, Heiko Schöder, Elad Sharon, Jedd Wolchok, Michael V Knopp, Richard L Wahl, Benjamin M Ellingson, Nathan C Hall, Martin J Yaffe, Alexander J Towbin, Michael D Farwell, Daniel Pryma, Tina Young Poussaint, Chadwick L Wright, Lawrence Schwartz, Mukesh Harisinghani, Umar Mahmood, Anna M Wu, David Leung, Elisabeth G E de Vries, Ying Tang, Gillian Beach, Steven A Reeves
Journal: The Lancet Oncology (2023)
Lenvatinib plus pembrolizumab versus sunitinib as first-line treatment of patients with advanced renal cell carcinoma (CLEAR): extended follow-up from the phase 3, randomised, open-label study
Authors: Toni K Choueiri, Masatoshi Eto, Robert Motzer, Ugo De Giorgi, Tomas Buchler, Naveen S Basappa, María José Méndez-Vidal, Sergei Tjulandin, Se Hoon Park, Bohuslav Melichar, Thomas Hutson, Carlos Alemany, Bradley McGregor, Thomas Powles, Viktor Grünwald, Boris Alekseev, Sun Young Rha, Evgeny Kopyltsov, Anil Kapoor, Teresa Alonso Gordoa, Jeffrey C Goh, Michael Staehler, Jaime R Merchan, Ran Xie, Rodolfo F Perini, Kalgi Mody, Jodi McKenzie, Camillo G Porta
Journal: The Lancet Oncology (2023)
Personalised progression prediction in patients with monoclonal gammopathy of undetermined significance or smouldering multiple myeloma (PANGEA): a retrospective, multicohort study
Authors: Annie Cowan, Federico Ferrari, Samuel S Freeman, Robert Redd, Habib El-Khoury, Jacqueline Perry, Vidhi Patel, Priya Kaur, Hadley Barr, David J Lee, Elizabeth Lightbody, Katelyn Downey, David Argyelan, Foteini Theodorakakou, Despina Fotiou, Christine Ivy Liacos, Nikolaos Kanellias, Selina J Chavda, Louise Ainley, Viera Sandecká, Lenka Pospíšilová, Jiri Minarik, Alexandra Jungova, Jakub Radocha, Ivan Spicka, Omar Nadeem, Kwee Yong, Roman Hájek, Efstathios Kastritis, Catherine R Marinac, Meletios A Dimopoulos, Gad Getz, Lorenzo Trippa, Irene M Ghobrial
Journal: The Lancet Haematology (2023)

Patients with precursors to multiple myeloma are dichotomised as having monoclonal gammopathy of undetermined significance or smouldering multiple myeloma on the basis of monoclonal protein concentrations or bone marrow plasma cell percentage. Current risk stratifications use laboratory measurements at diagnosis and do not incorporate time-varying biomarkers. Our goal was to develop a monoclonal gammopathy of undetermined significance and smouldering multiple myeloma stratification algorithm that utilised accessible, time-varying biomarkers to model risk of progression to multiple myeloma.
Declining Risk of Sudden Cardiac Death in Heart Failure: Fact or Myth?
Authors: Francisco Leyva, Carsten W. Israel, Jagmeet Singh
Journal: Circulation (2023)

The notion that the risk of sudden cardiac death (SCD) in patients with heart failure (HF) is declining seems to be gaining traction. Numerous editorials and commentaries have suggested that SCD, specifically arrhythmic SCD, is no longer a significant risk for patients with HF on guideline-directed medical therapy. In this review, we question whether the risk of SCD has indeed declined in HF trials and in the real world. We also explore whether, despite relative risk reductions, the residual SCD risk after guideline-directed medical therapy still suggests a need for implantable cardioverter defibrillator therapy. Among our arguments is that SCD has not decreased in HF trials, nor in the real world. Moreover, we argue that data from HF trials, which have not adhered to guideline-directed device therapy, do not obviate or justify delays to implantable cardioverter defibrillator therapy. In this context, we underline the challenges of translating the findings of HF randomized, controlled trials of guideline-directed medical therapy to the real world. We also make the case for HF trials that adhere to current guideline-directed device therapy so that we can better understand the role of implantable cardioverter defibrillators in chronic HF.
Time-Restricted Feeding Enhances Early Atherosclerosis in Hypercholesterolemic Mice
Authors: Chang Pan, Beatriz Herrero-Fernandez, Celia Borja Almarcha, Raquel Gomez Bris, Virginia Zorita, Angela Sáez, Sanne Lidewij Maas, Laura Pérez-Olivares, Andrea Herrero-Cervera, Patricia Lemnitzer, Kristof van Avondt, Carlos Silvestre-Roig, Jose Maria Gonzalez-Granado, Raphael Chevre, Oliver Soehnlein
Journal: Circulation (2023)
Fitness and Functional Landscapes of the<i>E. coli</i>RNase III Gene<i>rnc</i>
Authors: Ryan Weeks, Marc Ostermeier
Journal: Molecular Biology and Evolution (2023)

Abstract How protein properties such as protein activity and protein essentiality affect the distribution of fitness effects (DFE) of mutations are important questions in protein evolution. Deep mutational scanning studies typically measure the effects of a comprehensive set of mutations on either protein activity or fitness. Our understanding of the underpinnings of the DFE would be enhanced by a comprehensive study of both for the same gene. Here, we compared the fitness effects and in vivo protein activity effects of ∼4,500 missense mutations in the E. coli rnc gene. This gene encodes RNase III, a global regulator enzyme that cleaves diverse RNA substrates including precursor ribosomal RNA and various mRNAs including its own 5′ untranslated region (5′UTR). We find that RNase III's ability to cleave dsRNA is the most important determinant of the fitness effects of rnc mutations. The DFE of RNase III was bimodal, with mutations centered around neutral and deleterious effects, consistent with previously reported DFE's of enzymes with a singular physiological role. Fitness was buffered to small effects on RNase III activity. The enzyme's RNase III domain, which contains the RNase III signature motif and all active site residues, was more sensitive to mutation than its dsRNA binding domain, which is responsible for recognition and binding to dsRNA. Differential effects on fitness and functional scores for mutations at highly conserved residues G97, G99, and F188 suggest that these positions may be important for RNase III cleavage specificity.
A Triboelectric Nanocomposite for Sterile Sensing, Energy Harvesting, and Haptic Diagnostics in Interventional Procedures from Surgical Gloves
Authors: Carmen Salvadores Fernandez, Shireen Jaufuraully, Biswajoy Bagchi, Wenqing Chen, Priyankan Datta, Priya Gupta, Anna L. David, Dimitrios Siassakos, Adrien Desjardins, Manish K. Tiwari
Journal: Advanced Healthcare Materials (2023)

Advanced interfacial engineering has the potential to enable the successful realization of three features that are particularly important for a variety of healthcare applications: wettability control, antimicrobial activity to reduce infection risks, and sensing of physiological parameters. Here, a sprayable multifunctional triboelectric coating is exploited as a nontoxic, ultrathin tactile sensor that can be integrated directly on the fingertips of surgical gloves. The coating is based on a polymer blend mixed with zinc oxide (ZnO) nanoparticles, which enables antifouling and antibacterial properties. Additionally, the nanocomposite is superhydrophobic (self-cleaning) and is not cytotoxic. The coating is also triboelectric and can be applied directly onto surgical gloves with printed electrodes. The sensorized gloves so obtained enable mechanical energy harvesting, force sensing, and detection of materials stiffness changes directly from fingertip, which may complement proprioceptive feedback for clinicians. Just as importantly, the sensors also work with a second glove on top offering better reassurance regarding sterility in interventional procedures. As a case study of clinical use for stiffness detection, the sensors demonstrate successful detection of pig anal sphincter injury ex vivo. This may lead to improving the accuracy of diagnosing obstetric anal sphincter injury, resulting in prompt repair, fewer complications, and improved quality of life.
Clinical features in adults with acquired cutis laxa: a retrospective review
Authors: Katie A O’Connell, Morgan Schaefer, Lihi Atzmony, Ruth Ann Vleugels, Keith Choate, Avery H LaChance, Michelle S Min
Journal: British Journal of Dermatology (2023)

Acquired cutis laxa (ACL) is a very rare dermatological condition with numerous proposed aetiologies. Herein, we report on 10 adult patients with ACL, three of which were found to have genetic mutations suggesting a genetic predisposition for the development of ACL following exposure to an environmental insult. Four patients were presumed to develop ACL in association with medication exposure. Overall, if a case of potential ACL arises, providers should carefully review patient history and comorbidities, perform thorough systemic investigations based on symptomatology, and consider genetic analysis.
Improving outcomes of childhood and young adult non-Hodgkin lymphoma: 25 years of research and collaboration within the framework of the European Intergroup for Childhood Non-Hodgkin Lymphoma
Authors: Auke Beishuizen, Karin Mellgren, Mara Andrés, Anne Auperin, Chris M Bacon, Simon Bomken, G A Amos Burke, Birgit Burkhardt, Laurence Brugieres, Alan K S Chiang, Christine Damm-Welk, Emanuele d'Amore, Keizo Horibe, Edita Kabickova, Tasneem Khanam, Udo Kontny, Wolfram Klapper, Laurence Lamant, Marie-Cecile Le Deley, Jan Loeffen, Elizabeth Macintyre, Georg Mann, Friederike Meyer-Wentrup, Ulf Michgehl, Veronique Minard-Colin, Lara Mussolin, Ilske Oschlies, Catherine Patte, Marta Pillon, Alfred Reiter, Charlotte Rigaud, Leila Ronceray, Itziar Salaverria, Ingrid Simonitsch-Klupp, Anne Uyttebroeck, Jaime Verdu-Amoros, Denise Williams, Wilhelm Woessmann, Andrew Wotherspoon, Grazyna Wrobel, Martin Zimmermann, Andishe Attarbaschi, Suzanne D Turner
Journal: The Lancet Haematology (2023)
One-food versus six-food elimination diet therapy for the treatment of eosinophilic oesophagitis: a multicentre, randomised, open-label trial
Authors: Kara L Kliewer, Nirmala Gonsalves, Evan S Dellon, David A Katzka, Juan P Abonia, Seema S Aceves, Nicoleta C Arva, John A Besse, Peter A Bonis, Julie M Caldwell, Kelley E Capocelli, Mirna Chehade, Antonella Cianferoni, Margaret H Collins, Gary W Falk, Sandeep K Gupta, Ikuo Hirano, Jeffrey P Krischer, John Leung, Lisa J Martin, Paul Menard-Katcher, Vincent A Mukkada, Kathryn A Peterson, Tetsuo Shoda, Amanda K Rudman Spergel, Jonathan M Spergel, Guang-Yu Yang, Xue Zhang, Glenn T Furuta, Marc E Rothenberg
Journal: The Lancet. Gastroenterology & hepatology (2023)
The risks of death and hospitalizations associated with SARS-CoV-2 Omicron declined after lifting testing and quarantining measures
Authors: Yamin Deng, Shasha Han, Jue Liu, Li Guo, Luzhao Feng, Yilan Liao, Zhixing Peng, Lili Ren, Weizhong Yang, Jianwei Wang
Journal: Journal of Infection (2023)
A novel nucleotide-binding oligomerization domain 2 genetic marker for Yao syndrome
Authors: Brianne Navetta-Modrov, Hafsa Nomani, Mark Yun, Jie Yang, Joann Salvemini, Olga Aroniadis, Richard Clark, Peter D. Gorevic, Qingping Yao
Journal: Journal of the American Academy of Dermatology (2023)
Anticoagulation improves survival in patients with cirrhosis and portal vein thrombosis: The IMPORTAL competing-risk meta-analysis
Authors: Antonio Guerrero, Laura del Campo, Fabio Piscaglia, Bernhard Scheiner, Guohong Han, Francesco Violi, Carlos-Noronha Ferreira, Luis Téllez, Thomas Reiberger, Stefania Basili, Javier Zamora, Agustín Albillos, Dominique Valla, Francois Durand, Tomás Artaza, Juan Carlos García-Pagán, Marta Magaz, Vincenzo La Mura, Massimo Primignani, Angelo Luca, Carol Stanciu, Marco Senzolo, Lucio Amitrano, Horia Stefanescu, Filipe Nery, Sylvie Chevret, Irina Girleanu
Journal: Journal of Hepatology (2023)
A Polypyrrole‐Polycarbonate Polyurethane Elastomer Alleviates Cardiac Arrhythmias via Improving Bio‐Conductivity
Authors: Monir Riasad Fadle Aziz, Lukasz Wlodarek, Faisal Alibhai, Jun Wu, Shuhong Li, Yu Sun, J. Paul Santerre, Ren‐Ke Li
Journal: Advanced Healthcare Materials (2023)

Myocardial fibrosis, resulting from myocardial infarction (MI), significantly alters cardiac electrophysiological properties. As fibrotic scar tissue forms, its resistance to incoming action potentials increases, leading to cardiac arrhythmia, and eventually sudden cardiac death or heart failure. Biomaterials are gaining increasing attention as an approach for addressing post-MI arrhythmias. The current study investigates the hypothesis that a bio-conductive epicardial patch can electrically synchronize isolated cardiomyocytes in vitro and rescue arrhythmic hearts in vivo. A new conceived biocompatible, conductive, and elastic polyurethane composite bio-membrane, referred to as polypyrrole-polycarbonate polyurethane (PPy-PCNU), is developed, in which solid-state conductive PPy nanoparticles are distributed throughout an electrospun aliphatic PCNU nanofiber patch in a controlled manner. Compared to PCNU alone, the resulting biocompatible patch demonstrates up to six times less impedance, with no conductivity loss over time, as well as being able to influence cellular alignment. Furthermore, PPy-PCNU promotes synchronous contraction of isolated neonatal rat cardiomyocytes and alleviates atrial fibrillation in rat hearts upon epicardial implantation. Taken together, epicardially-implanted PPy-PCNU could potentially serve as a novel alternative approach for the treatment of cardiac arrhythmias.
Multicenter randomized trial comparing diagnostic sensitivity and cellular abundance with aggressive versus standard biliary brushing for bile duct stenosis without mass syndrome
Authors: David Karsenti, Jocelyn Privat, Aurélie Charissoux, Bastien Perrot, Sarah Leblanc, Ulriikka Chaput, Isabelle Boytchev, Jonathan Levy, Marion Schaefer, Jean-François Bourgaux, Jean-Christophe Valats, Emmanuel Coron, Maira Moreno-Garcia, Geoffroy Vanbiervliet, Gabriel Rahmi, Enrique Perez-Cuadrado Robles, Timothée Wallenhorst
Journal: Endoscopy (2023)

BACKGROUND : The diagnosis of cholangiocarcinoma in patients with a biliary stricture without mass syndrome can be obtained by biliary brushing with a sensitivity of ~50 %. We performed a multicenter randomized crossover trial comparing the aggressive Infinity brush with the standard RX Cytology Brush. The aims were to compare sensitivity for cholangiocarcinoma diagnosis and cellularity obtained. METHODS : Biliary brushing was performed consecutively with each brush, in a randomized order. Cytological material was studied with blinding to the brush type used and order. The primary end point was sensitivity for cholangiocarcinoma diagnosis; the secondary end point was the abundance of cellularity obtained with each brush, with cellularity quantified in order to determine if one brush strongly outperformed the other. RESULTS : 51 patients were included. Final diagnoses were cholangiocarcinoma (n = 43; 84 %), benign (n = 7; 14 %), and indeterminate (n = 1; 2 %). Sensitivity for cholangiocarcinoma was 79 % (34 /43) for the Infinity brush versus 67 % (29/43) for the RX Cytology Brush (P = 0.10). Cellularity was rich in 31/51 cases (61 %) with the Infinity brush and in 10/51 cases (20 %) with the RX Cytology Brush (P < 0.001). In terms of quantification of cellularity, the Infinity brush strongly outperformed the RX Cytology Brush in 28/51 cases (55 %), while the RX Cytology Brush strongly outperformed the Infinity brush in 4/51 cases (8 %; P < 0.001). CONCLUSIONS : This randomized crossover trial showed that the Infinity brush is not significantly more effective than the RX Cytology Brush for biliary stenosis without mass syndrome in terms of sensitivity for cholangiocarcinoma diagnosis, but does offer a significantly higher abundance of cellularity.
Incorporating Tantalum Oxide Nanoparticles into Implantable Polymeric Biomedical Devices for Radiological Monitoring
Authors: Kendell M. Pawelec, Ethan Tu, Shatadru Chakravarty, Jeremy M. L. Hix, Lane Buchanan, Legend Kenney, Foster Buchanan, Nandini Chatterjee, Subhashri Das, Adam Alessio, Erik M. Shapiro
Journal: Advanced Healthcare Materials (2023)

Abstract Longitudinal radiological monitoring of biomedical devices is increasingly important, driven by the risk of device failure following implantation. Polymeric devices are poorly visualized with clinical imaging, hampering efforts to use diagnostic imaging to predict failure and enable intervention. Introducing nanoparticle contrast agents into polymers is a potential method for creating radiopaque materials that can be monitored via computed tomography. However, the properties of composites may be altered with nanoparticle addition, jeopardizing device functionality. Thus, the material and biomechanical responses of model nanoparticle‐doped biomedical devices (phantoms), created from 0–40 wt% tantalum oxide (TaO x ) nanoparticles in polycaprolactone and poly(lactide‐co‐glycolide) 85:15 and 50:50, representing non, slow, and fast degrading systems, respectively, are investigated. Phantoms degrade over 20 weeks in vitro in simulated physiological environments: healthy tissue (pH 7.4), inflammation (pH 6.5), and lysosomal conditions (pH 5.5), while radiopacity, structural stability, mechanical strength, and mass loss are monitored. The polymer matrix determines overall degradation kinetics, which increases with lower pH and higher TaO x content. Importantly, all radiopaque phantoms could be monitored for a full 20 weeks. Phantoms implanted in vivo and serially imaged demonstrate similar results. An optimal range of 5–20 wt% TaO x nanoparticles balances radiopacity requirements with implant properties, facilitating next‐generation biomedical devices.
Reproductive Health Policy in the United States: An American College of Physicians Policy Brief
Authors: Josh Serchen, Shari Erickson, David Hilden, Suja Mathew, David Hilden, Micah Beachy, William Curry, Matthew Hollon, Cynthia Jumper, Pranav Mellacheruvu, Marianne Parshley, Ankita Sagar, Jamar Slocum, Michael Tan, Vanessa Van Doren, Elham Yousef
Journal: Annals of Internal Medicine (2023)

The legal landscape around access to reproductive health care services was substantially altered after the Supreme Court decision in Dobbs v Jackson Women's Health Organization. In the aftermath of the decision, some state governments have begun to impose stringent restrictions and complete bans on the provision of abortion, whereas others have sought to protect and expand access. Some have gone as far as imposing criminal and civil penalties on physicians and other clinicians who provide evidence-based, clinically indicated reproductive health care services and information that is guided by biomedical ethics and provided in the best interest of the patient's health and well-being. In several states, lawmakers have attempted and successfully used new approaches to enforcing and achieving these prohibitions, including prohibitions on crossing state lines to obtain abortion care, prohibitions on the mailing of medication abortion, and the authorization of third-party civil lawsuits. In this policy brief, the American College of Physicians (ACP) updates and expands on its previous public policy positions on abortion from its 2018 policy paper, "Women's Health Policy in the United States," to reflect this new reality. The College also offers policymakers and payers recommendations to promote equitable access to reproductive health care services and safeguard maternal health. ACP reaffirms its opposition to undue and unnecessary governmental interference in the patient-physician relationship that criminalizes the provision of health care made in the physician's clinical judgment and based on clinical evidence and the standard of care.